Wound Dressings

There are more than 3,000 types of wound dressings available on the market today; making it is easy to become overwhelmed by the options. The secret to understanding the various types of wound dressings is to learn the basic properties of the eight main categories of wound dressings. The dressings within each category are not identical; however, they do possess many of the same properties. This section provides detailed information on the properties of the eight main categories of wound dressings.

Traditionally, gauze wound dressings were made from woven or nonwoven gauze. Gauze dressings continue to be the most readily available wound dressings in use today. Gauze is highly permeable and relatively non-occlusive. Therefore, gauze dressings may promote desiccation in wounds with minimal exudate unless used in combination with another dressing or topical agent. Gauze may be used as a primary or secondary wound dressing. Gauze dressings are inexpensive for one-time or short-term use. Gauze dressings come in many forms: squares, sheets, rolls, and packing strips.

Film dressings are thin, flexible sheets of clear polyurethane combining an adhesive coating on one side to allow adherence to the skin. The adhesive reacts with wound exudate to prevent adhesion to the wound bed, while allowing the film to stick to the dry, skin surrounding the wound. Film dressings are highly elastic and conformable to body contours, and are suitable for use either as a primary or secondary dressing. The transparent quality of film dressings allows visualization of the wound.

Hydrogel wound dressings are 80% to 99% water-or-glycerin-based wound dressings that are available in sheets, gels, or impregnated gauzes. Hydrogels can only absorb a minimal amount of fluid. But since they contain high water/glycerin content they are able to donate moisture to dry wounds. When applied to the skin or wound, they feel cool and may decrease wound pain. But, hydrogels are permeable to gas and water, making them less effective bacterial barriers than semipermeable films or hydrocolloids. And, they may dehydrate easily, particularly if water based. Almost all hydrogels are non-adhesive and require a secondary dressing.

Foam wound dressings are sheets and other shapes of foamed polymer solutions (most commonly polyurethane) with small, open cells capable of holding fluids. They may be impregnated or layered in combination with other materials. Absorption capability depends on thickness and composition. The area in contact with the wound surface is non-adhesive for easy removal. Available with an adhesive border and/or a transparent film coating that acts as a bacterial barrier. Indicated for partial- and full-thickness wounds.

Alginate wound dressings are made from brown seaweed. When placed within the wound bed, alginate dressings react with serum and wound exudate to form a gel. This gel provides a moist wound environment and may trap bacteria, which can then be washed away during dressing changes. It is important not to confuse this gel for infection. Alginates are highly permeable and nonocclusive. Therefore, they require a secondary dressing, most commonly gauze. Alginates are available in three forms. Alginate sheets may be placed on wound beds to absorb drainage. Alginate ropes are used to tightly fill wound tunnels or areas of undermining. And alginate-tipped applicators can be used to probe wounds, fill wound cavities and tunnels perform swab cultures, and measure wound depth. Hydrofibers are dressings made from sodium carboxymethylcellulose. These dressings are similar to alginates in appearance, use, and precautions, and are often used interchangeably with alginates.

Composite or combination wound dressings, are multi-layer dressings that can be used as primary- or- secondary wound dressings. Most composite dressings have three layers. The inner contact layer is non-adherent, preventing trauma to the wound bed during dressing changes. The middle layer absorbs moisture, and wicks it away from the wound bed to prevent maceration, while maintaining a moist wound environment. This middle layer may consist of a hydrogel, semi-permeable foam, hydrocolloid, or alginate. The outer layer serves as a bacterial barrier, and is commonly composed of a semi-permeable film. Because composite dressings are prepackaged, they have less flexibility in terms of indications for use, and buying and storing these dressings can be quite costly.

Hydrocolloid wound dressings contain hydrophilic colloidal particles such as gelatin, pectin, and cellulose, and have a very strong film or foam adhesive backing. This class of dressings varies greatly in absorption abilities. Hydrocolloids absorb exudate slowly by swelling into a gel-like mass. Upon removal, a residue commonly remains within the wound bed. Because this residue may have a foul odor, it is often mistaken as a sign of infection. Hydrocolloids come in a variety of sizes and precut shapes. Several hydrocolloids have beveled edges to reduce the tendency for the dressing to roll when placed in high-friction areas. Hydrocolloids provide thermal insulation to the wound and are impermeable to water, oxygen, and bacteria. Wounds dressed with hydrocolloids have lower infection rates than wounds covered with gauze, semipermeable films, sheet hydrogels, or semi-permeable foams.

Wound dressings are sometimes described as passive, active, or interactive. While passive dressings simply serve a protective function, active dressings actually promote healing through the creation of a moist wound environment. Interactive dressings, on the other hand, not only create a moist wound environment but also interact with the wound bed components to further enhance wound healing.

Types of Wound Dressings – Additional Resources

Traditionally wet-to-dry gauze has been used to treat wounds. Wound dressings that create and maintain a moist environment, however, are now considered to provide the optimal conditions for wound healing. Use the resources below to learn more about the various types of wound dressings.

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